Martha E Fagan, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01066632A Issued in IN

Practice address

1050 Reid Parkway
Suite 220
Richmond, IN 47374-1156

Phone

(765) 962-9541

Fax

(765) 966-5952

NPI assigned

Jan 19, 2006

Last updated

May 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mfagan301884@reidhealth.direct-ci.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1831179373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 REID PARKWAY",
            "address_2": "SUITE 220",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741156",
            "telephone_number": "765-962-9541",
            "fax_number": "765-966-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 REID PARKWAY",
            "address_2": "SUITE 220",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741156",
            "telephone_number": "765-962-9541",
            "fax_number": "765-966-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "MARTHA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01066632A",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101233798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200946410",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3033461",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfagan301884@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1050 Reid Parkway",
            "address_2": "Suite 220",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marcus L. Ewing Jr., MSW
• Eye Center Group LLC (Richmond Eye Center)
• Eye Center Group, LLC (Richmond Eye Center)
• Eyes 2020 Inc. (Opti Vision 2020)
• Eyes 2020 Inc. (Opti Vision 2020)
• Adebisi Mary Fagbohun, MD
• Christina Marie Falcone
• Krista Michelle Falcone, BS, FCP
• Anthony P Farley, NPC
• Christine J Farris, M.D.

• Obstetrics & Gynecology Physician in Richmond, IN
• Providers in Richmond, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.